About

This site was developed by Paul Fischer and Brian Klepper as a service in the public interest.

Paul Fischer MD is based in Augusta, Ga, and has practiced family medicine for 33 years.

His first practice was a solo rural one in Weeping Water, Nebraska. He moved from there to the Medical College of Georgia where he was a professor of Family Medicine. While there, he published an article in JAMA showing that children as young as 4 years old, routinely recognize “Old Joe” the Camel cigarette character. This led to a long legal battle with the tobacco industry that was in part responsible for the state Attorney Generals’ successful suit against the tobacco industry.

He also completed research on office laboratory testing and served as a consultant on this issue to the AAFP, CDC, and College of American Pathologists.

Fifteen years ago, he left his academic position and started the Center for Primary Care in Augusta, GA which has since grown to a 30 family physician group practice. He turned over the CEO position for the group 8 years ago and now spends most of his time in direct patient care.

Brian Klepper, PhD is a health care analyst, consultant and commentator. He is Managing Principal of Healthcare Performance Inc., a business development practice based in Atlantic Beach, FL, and Chief Development Officer forWeCare TLC, LLC, an onsite clinic firm based in Lake Mary, FL.

An active author and speaker, Dr. Klepper has provided health care commentary to CBS Evening News, the Wall Street Journal, the New York Times, and the Washington Post, and has published articles on Medscape and Healthleaders, and in The New England Journal of Medicine, Modern Healthcare, Business Insurance and newspapers nationally.

Specialist-PCP Hourly Earnings Under MFS

Read This First! Why Did We Develop This Site?

This site has been developed - see here for our backgrounds - to help primary care physicians and other interested individuals obtain verifiable background from reputable sources on:

The evolution and structure of the US' medical payment system.

How it came to devalue primary care and favor specialty services.

How that has translated to lower quality care at far greater expense in the US.

We believe the overwhelming majority of American primary care physicians are deeply frustrated with the differences in how primary and specialty care are valued by the current system, and the havoc that system has wrought throughout health care and the nation.

The first step to remedying this situation is for the primary care medical societies to visibly and loudly withdraw from participation in the RUC, de-legitimizing the process.

That said, this effort is most decidedly NOT primarily about getting primary care physicians more money, but bringing our health system back into homeostasis.

Together, perhaps we can facilitate a process to replace the RUC with a more balanced, independent advisory panel to the Centers for Medicare and Medicaid Services (CMS).

Then the next step would be to urge replacement of the current, highly jiggered reimbursement methodology, the Resource-Based Relative Value Scale (RBRVS), with another approach that is more modern, enlightened and focused on value. We believe that a core principle of a revised payment system is payment parity for management of complexity.

This is likely to be a process that takes time, so we'll update this site daily to reflect the latest information. Please visit often to stay in touch. And if you think this is important and worthwhile, please pass this site along to your colleagues.